Airman Records for Alleged 9/11 Hijacker Marwan Alshehhi

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    Airman Records onSeptember 11th Hijackers andIndicted Co-conspirators

    For

    NAMEZACARIAS MOUSSAOUIMedical RecordsRecord of Diligen t SearchA LI AYEDH AL-GHAMDIM A R W A N YOUSEF ALSHEHH IMOHA MED ATTAHA N I SALEH H ANJOORZIAD JARRAH

    TRACKING #

    100110231002

    1003

    1005

    1006

    1007

    WARNING; THIS DOCUMENT CONTAINS SENSITIVE SECURITY INFORMAT ION THAT IS CONTROLLEDUNDER THE P RO VISIONS OF 49 CFR PART 1520. NO PART OF THIS DOCUM ENT MAY BE RELEASEDWITHOUT THE W RITTEN PERM ISSION OF THE UNDER SECRETARY OF TRANSPORTATION FORSECURITY, W A S H I N G T O N , DC 20590. UNAUTHOR IZED RELEASE M AY RESULT IN CIVIL PENALTY OROTHER ACTION. FOR U.S. GOVERNM ENT AGENCIES, PUBLIC AVAILABILITY TO BE DETERMINEDUNDER 5 U.S.C. 552.

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    TSA/ACS-90 493-509130 May 2002

    Airman Records of September 11 Hijackers and Indicted Co-Conspirators At the request of the Department of Justice in the U.S. v. Moussaoui case, this officeprovided a list of 25 names and all known aliases (see Tab 1) to the FAA Civil AviationRegistry an d requested that they search the ir files for any airman records on theseindividuals. In addition to Mo ussaoui, the nam e list consisted of the nineteenSeptember 1 1 th hijackers and the othe r five indic ted co-conspirators. For any recordsidentified, the Registry was asked to provide a DOT Form 2100.1 "Certificate of True

    Copy," often referred to as a Blue Ribbon copy. By way of background, the FAA Civil A viation Reg istry located in Oklahoma City maintainsextensive records on every certificated airman (those who possess a U.S.-issued airman

    certificate) and all U.S. registered aircraft. Airman Records on six of the individuals on the Name List were located and Blue Ribbon

    copies of their records are enclosed:> Zacarias Moussaoui> Ali Ayedh Al-Ghamdi> Marwan Yousef Alshehhi> Mohamed Atta> Hani Saleh Hanjoor> Ziad Jarrah

    An airman record on a seventh individua l on the Name List (Waleed Ahmed Al-Shehri) w asalso id entified . It was later discovered that this record belonged to an ind ividu al who is stillalive and a pilot for a Saudi diplom at. He is not the same individ ual as one of the September1 I th hijackers whose name is actually Waleed Mohamed Al-Shehri. Tab=8-contains emailcorrespondence docum enting this. According ly, his airman record is not included. The airman file at the Registry contains th e com plete history of an airman from the time heor she was first issued a certificate. Includ ing all types of airmen, there are approxima tely1,000,000 airmen files, of which approximately 626,000 are pilots. Th e levels of pilotcertificates are student, recreational, private, com mercial, an d airline transport. Some 81 ,000airmen are also flight instructors, and there w ould be a separate airman file under their flightinstructor certificate. The airman file rema ins "open" until the FAA is no tified of theairman's death. The file is only "closed" upon receipt of a death certificate. The followingare descriptions of the types of docum ents to be found in an airman record:

    SENSITIVE SECURITY INFORM ATIONWARNING: This documen t co ntains sensit ive security informat ion that is control led under the provisions of49 CFR 1520. Th e in format ion may not be released in any form without the express prior w ritten consent ofthe Under Secretary of Transportation for Security. In accordance w i th 49 U.S.C. 40119, this information isexempt by statute from disclosure under the FOIA. Under the provisions of 49 CFR 1520(d), v iolators ar esubject to civil penalty or other action by DOT.

    NCTA000010812

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    > Airman M edical. The airman medical certificate is issued by a FAA-appointed aviationmedical examiner who is a medical doctor with specific aerospace medicine training.Issuance of the med ical certificate indicates that the bearer, at least for the day ofissuance, is medically qualified to exercise the privileges of his or her airman certificate.

    > Airma n Certificate. The airman certificate is a permanen t p ilot certificate issued uponreceipt at the Airman Registry of the certification file - application, written test results ifapplicable, superseded pilot certificate, an d copy of temporary airman certificate. Theairman certificate lists the category an d class of aircraft the airman may operate (e.g.,airplane single engine land) and any ratings (e.g., instrum ent or type rating) or limita tions(e.g., not valid fo r compensation or hire). The certificate also include s the f u l l name ofthe airman, address, and physical description.

    > Temporary Airman Certificate. The temporary airman certificate is issued by adesignated pilot examiner (unless the practical test is given by an inspector) uponsuccessful completion of a practical test by an applicant. The temporary airmancertificate is valid for 120 days or until the pilot receives his permanent airmancertificate, at which point the temporary should be destroyed. (However, some pilotskeep them as souvenirs, but an expiration date is on the temporary.)

    > Airman Certificate/Type Rating App lication. The Airman Certificate/Rating Applicationis used by airman to apply for all levels of airman c ertifica te, ratings, or typ e ratings. Theapplication is filled out by the airman and endorsed by the flight instructor givin g theinstruction for the particular certificate or rating to indicate that the applicant is qualifiedto take the practical test. Finally, the designated pilot examiner (o r inspector) certifiesthat the applicant has either passed or failed the practical test.> Airman W ritten Test R esults. All airman written testing is conducted at FAA-approvedtesting centers. These are standardized test adm inistrators who can dem onstrate a highlevel of inform ation security. Results of the written test include the airman's score(expressed as a percentage of the total num ber of questions), and lists the areas of airmanknow ledge the applicant answered incorrectly. The airman m ust present a copy of apassed written test to apply for the certificate or rating being sought. A practical testcannot occur unti l the applicant has passed the written test.> Student Pilot Certificate. The student pilot certificate is issued to any non-pilot who isseeking to becom e either a private or recreational pilot. In most cases it is a combinedstudent pilot/med ical certificate fo r powered aircraft. (A medical certificate is notrequired for gliders or balloons.) On the student pilot side of the certificate the instructor

    endorses wh en the student is ready to solo and condu ct solo cross-country flights. Whenthe private or recreational pilot certificate is issued, the combined student pilot/medicalcertificate is not submitted with the application because it still serves as the student'sSENSITIVE SECURITY INFORMATION

    WARNING; This docum ent contains sensitive security information that is control led un der th e provisions of49 CFR 1520. The information may not be released in any form without the express prior written consent ofth e Und er Secretary of Transportation fo r Security. In accordance with 49 U.S.C. 40119, this information isexempt by statute from disclosure under the F O I A . Under the prov isions of 49 C FR 1520(d), violators aresubject to civil penalty or other action by DOT.

    NCTA000010813

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    medical certificate. Once that expires, a new, medical-only certificate is obtained by thepilot.Notice of Disapproval of Ap plication. The notice of disapprov al is colloquially referredto as a "pink slip" because the y used to be printed on salmon-colored paper. This isissued to an applicant who fails the practical test for a certificate or rating. On the noticethe examiner (o r inspector) lists by task number th e maneuvers required by the PracticalTest Standards that the applicant failed to perform successfully.Acciden t/Incident History. This wo uld list all accidents, incidents, etc., in which th e pilotwas involved. (The definit ion of accident an d incident is found in NTSB 830.) Thiswould inclu de date, time, aircraft, etc. The information is taken from the FAAAccident/Incident report form.Enforcement Activity. This would include the airman's enforcement history, i.e., thenum ber of times h e or she has been investigated for an act of non-compliance with any ofTitle 14, Code Federal Regulations. The type of infraction plus the penalty would beincluded.

    SENSITIVE SECURITY INFORMATIONW A R N I N G : This document contains sensitive security inform ation that is controlled under th e provisions of49 CFR 1520. The information may not be released in any form without th e express prior written consent ofth e Und er Secretary of Transportation fo r Security. In accordance with 49 U.S.C. 40119, this information isexempt by statute from disclosure under the FOIA. Under the provisions of 49 CFR 1520(d), violators aresubject to civil penalty or other action by DOT.

    NCTA000010814

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    D a t e : 5/9/2002 9:31 AMSender: Mike MorseTo: Carla Martin[OST]

    D a v i d CTR GracesonMark RandolP r i o r i t y : NormalSjjbjject:_Fwd:AL-SHHRl.Waleed AhmedCarla - Suggest you forward this to DoJ immediately. As the airman certificationinformation previously provided to FBI and provided by us to John, concerning AL SHEHRl,appears to NOT BE RELEVANT TO THE HIJACKER OF THAT NAME.Accordingly the At Shenri information needs protection from a personal privacy point of view.

    Michael A. Morse, ManagerSpecial Actions & Litigation S upport S taffAssociate Under Secretary for Aviation Security Operations[TSA/ACS-90] (202)267-9771 911Personal Privacy

    F o r w a r d H e a d e rS ub j e c t : A L - S H E H R I, W a l e e d A h m e dAuthor: M a r k S w e e n e yDa t e : 5/8/2002 12:40 PM

    W e w e r e r e c e n t l y n o t i f i e d t h a t W a l e e d A h m e d A L - S H E H R I , s s nw h o h ad b e e n i d e n t i f i e d b y t h e F B I a s on eo f t he 1 9 t e r r o r i s t s h a d been i s s ue d a m e d i c a l c e r t i f i c a t e i n F e b r ua r y2002. Our office c o n ta c t e d the FBI who i n t e r v i e w e d Mr. AL-SHEHRI andd i s c o v e r e d he was not one of the h i j a c k e r s but was in fact a p i l o t for aS au d i D i p l o m a t and was v e ry mu c h a l i v e . The i d e n t i t y of the h i j a c k e r wasi n fact W a l e e d M o h a m e d A L - S H E H R I wh o i s n o t c e r t i f i c a t e d by the FAA.F or AMC-760, p le a s e r e m ov e the "no m a i l " r e s t r i c t i o n .

    M a r k Sweeney, AMC-730Int e r na l S e cu r i ty & Inve s t ig at i o n s D ivi s i o n(405) 954-5622

    NCTA000010815

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    U.S. DEPARTMENT OF TRANSPORTATIONFEDERAL AVIATION ADMINISTRATION

    RECORD OF DILIGENT SEARCHI HEREBY CERTIFY that I am custodian of the Federal Aviation Adm inistration airman records w hich aremaintained at Oklahoma City, Oklahoma; that a recent diligent search of such records has been made butthat no record or en try has been found to exist wh ich discloses that Z acarias Moussaoui was ever issued arecreational pilot or higher level airman certificate.

    Signed and dated at Oklahoma City, Oklahomathis 25th day of April. 2002

    by Jackie GuthrieSupervisor, Certification S ection D(Title)

    \Y CERTIFY that Jackie Guthriewh o signed the foregoing certificate is now, and was, at the time of signing S upervisor, CertificationSection D, the legal custodian of the aforesaid records, and that full faith and credit should be given thiscertificate as such.

    IN WITNESS WHEREOF, I have hereunto subscribedmy name and caused the seal of the U.S. Department ofTransportation to be affixedthis 251h day of April, 2002at Oklahoma City, Oklahoma

    Harol verett

    AC Form 8060-15 (10-94) (0052-545-3000)

    (Signature)Manager, Airmen Certification Branch(Title)Civil Aviation Reg istryU . S. Department of Transportation

    NCTA000010824

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    DEPARTMENT OF TRANSPORTAT ION

    CERTIFICATE OF TRUE COPY

    I HEREBY CERTIFY that the attached is a true copy of the originalmedical record of Z A C A RI A S M OUS S A OUI dated March 1, 2001,

    }le in the Aerospace M edical Certification Divisionlat I am the legal custodian thereof.Signed and dated at Oklahom a City, Oklahom athis 25th da y of Ap ril, 2002

    by JERRY K BOW EN

    I HEREBY CERTIFY that

    Supervisor, Medical Records SectionAerospace Medical Certification Division(Title)Civil Aerospace Medical Institute

    JERRY K BOWENIsigl^Bthe foreg oing certificate is now, an d was, at the time of signingpgal^Btodian of the aforesaid records,

    ith and credit sho uld b e given his certificate as such.IN WITNES S WHEREOF, I have hereunto subscribedmy nam e and caused the seal of the Departm ent ofTransportation tobe affixed this _ 25thday of A pril, 2002at Oklahoma City, Oklahoma

    WARREN S. SILBERMAN, P.O., M.P.H.( S i g n a t u r e )Manager, Aerospace Medical Certification Division

    ( f i f i e )Civil Aerospace Medical Institute

    Department of Transportation

    Form D O T F 2 1 0 0 . 1 1 9 - 6 9 )

    NCTA000010825

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    (Except For Shaded Areas)1ApplicationFor:. /.. ,:> - - - :rjAirman Medical' CavwrmanMedical and..-" Certificate v/,HStudent PlotCertificate -3. Last Name -,"'4.SoclilSecurity Number

    y-y yT

    10.Typ*of Alnnan.CertMlct*()You Hold:DNbiia DATCSr>edaJbt- Dr%MJnrtitwtbr :DRaereatlonal-D^AWIn* Transport DFightEngneer '."DPrivate - ' ' ' - .-.-XtDOCwr .

    . DFightNavfgator:': .OStudnt: :. - ! .1. Occupation

    13. Ha* Your FAAAirman Itedlcal CMtlfleate Ever Been Denied, Sutpended, orRevoked ?..DVe HNo . ... ..,. lfya.Blvdat

    74.DoYouCurrently UM Any Medication (PreaerlpUon or Nonpreacrlotlon)?No O Ye (Hyee, t*ow tut rratfcation. DoYou EverUUNearVnitonConlacJ.MediciHHMtf- HAVE YOUEVER IN YOURLIFtBEEN DIAGNOSED WITH. HAP,OR CO YOUPRESENT!for every condlflon lifted below .In'the EXPLANATIONS box below you may note PREVIOUSLY REPORTS- tepCfWd.orrrprsvtousapplication for an airmanmedicalcertUcaMand herembeennochang* InyouuandttiwP Frequentor sever*heodacnu

    BUnconseiousnftss (oranyreasonQ Eye orvision troubleexceptga$MS

    r.O SAslnrna or lung diseaseConvictionand/orAdmlnlatraU

    Form Approved OMB NO. 2120-0014*.C/ofM4IcalC

    1stFlnrtNam*1- Middle NarK*'

    Number!

    7r Color ofHair

    1ZEmployer

    M M / O D / Y Y Y Y18. Data ofLwt FAA MedicalApplluUon"U M / O O / V Y V Y NoFMw

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    NOTE: FAA/Original Copy of the Report of Modical Examination Must be TYPED.REPORT OF MEDICAL EXAMINATION

    22.VVtlgM: (pound*) 1 23, Stttmntof Pnon*tratod Ability (SODA): :D'VES : '.: D.iio . - . . ' - ; J4. SODA af1lrVumbfCHECK EACH ITEM INAPPROPRIATE COLUMN Horn* Atooonn CHECK EACH ITEM INAPPROPRIATE COLUMN NormJ ACooond25. Head, faca. neck, and scalp 37. Vascular system (Tula*. mpW ndamttHr. mi. * ) , Esophoria Exophorfa Right Hyperphorla LeftHypeVphorfaBlood Pressure

    _ - " " * ISysfelle I6.PulM'

    mmofMXairy) : / ; - > ! 57. Urtnalyslii (Ifabnomol, glveresufls)P Normal ..- ' D Abnormalv . Albumin

    58. ECG (Date)MM I DP I V'Y YY

    59. Other Tests Ghren

    60. Comments on History and Findings: AME shall comment on all "YES" answers'In the Medical History section and forabnormal findings of the examlnalfpn. (Attach an consultation reports, ECGs, X-rays, etc. tdthit report before mailing:)

    Significant Hadlcal Hlrtory D YE8 Abnormal Physical Finding* D Y C S .OMb

    41.Applicant's Name 6Z HasBeen Issued OMedical Certjficate ' C^Mircal& Student PDot Certrficato

    - D No CertMcate IssuedDeferred for.Further EvaluationD^HaaBeen Denied Lflttef.of Denial Issued (CopyAttached)63.Disqualifying Defects (List by Hem number)

    64. MedlcaKExamlner> Declaration-Ihereby certify that I have personally reviewed themedical history and personally *xamiried the:af!)cant narhed onthis medical examination report This report with anyattachment embodiesmy indingscompletely andconeclry^ . ^ ytawu&mnamea pri;Date of ExaminationJ"M | D P j.YYY Y Aviation Medical Examiner's NameStreet Address' ' ' ': . ^^

    FAA Form 8500-8 (i-8>) Supwaod** Praviou* EdrtonZip Code

    Aviation Medical Examiner's Sgnature '

    AMESerial NumberAMETelBphona ;( ).

    NCTA000010827

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    -342 Appl. ID: 1999301110 1. App! forCert. Applied Q1st[X]2ndD3rd 3. Last: MOUSSAOUI

    l,gso GODOARD AVE tt FLIGHT05/30/1968 Citizenship:

    o. Type ofAirman Certificate(s) You Hold:] Airline Transport[X] Commercial11. Occupation: STUDENT13. Has Your FAAAirman Medical Certificate Ever Been Denied, Suspended, or revoked?Total Pilot Time (Civilian Only) 14. To Date: 0 15. Past 6 months: 0

    City: NORMAN7. HairClr.: BLACK

    D NoneQ ATC SpecialistQ Flight Navigator

    [] Airman Med. Cert. (X) Airman Med. and Student Pilot Cert.First: ZACARIAS Middle: 4. SSN: 888-01-3454

    St.: OK/Cou.: Zip: 73069-8469 Tel.:8. Eye Clr.: BLACK

    [] Studentfj Flight Instructor[] Flight Engineer

    12. Employer NONEQYes[X]No

    16. Last FAA Med. App.Dale.

    9. Sex: male0, OtherQ RecreationalQ Private

    If yes.give Date:[X] No PriorApp.

    17.a. Do You Currently Use Any Meds. (Prescription or Nonprescription)? [XJNofJYes (If yes, list medication(s) used below.) Prev Reported

    17.b. Do You Ever Use Near Vision Contact Lens(es) While Flying? fJYes[X)No18 Medical History - HAVE YOU EVER INYOUR LIFE BEEN DIAGNOSED WITH, HAD. OR DO YOUPRESENTLY HAVE ANY OF THE FOLLOWING?

    Answer "yes" or "no" for every condition listed below. In the EXPLANATIONS box below, you may note "PREVIOUSLY REPORTED, NOCHANGE" only ifthe explanation of the condition was reported on a previous application for an airman medical certificate and there has been no change in your condition.Ye s

    QDDGQ0

    Conditiong Heart or vascularh High or lowbloodi Stomach, liver,or) Kidney stone ork DiabetesI Neurological disorders:

    YesflDQDQ

    epitepi

    Conditionm Mental disorders of any sort:n Substance dependence or failedo Alcohol dependence orabusep Suicide attemptq Motion sickness requiring

    YesQDaaD

    Conditionr Military medicals Medical rejection byt Rejectionfor life oru Admission to hospitalx Other illness, or

    Conditiona Frequent or severe headachesb Dizziness orfainting spellc Unconsciousness for anyd Eye or vision trouble, excepte Hay fever or allergyf Asthma or lung diseases

    Conviction and/or Administrative Action Historyv History of (1) any conviction(s) involving driving while intoxicated by.while impaired by, or while under the influence ofalcohol or a drug; or (2)history o f any conviction(s) or administrative action(s) involving anoffense(s) which resulted in the denial, suspension, cancellation, or revocation ofdriving privileges orwhich resulted in attendance at an educational or a rehabilitation program.w Non-traffic conviction(s) (misdemeanors or felonies).

    Explanations:NONE

    J9. Visits to Health Professional Within Last 3 YearsName Street City St Zip Country Type Reason

    YesDDaDD0

    Ye s0

    20. Applicant's National Driver Register and Certifying Declarations:REPORT OF MEDICAL EXAMINATION21. Height (Inches) 22. Weight (Ibs) 23. Statement of Demonstrated Ability (SODA)

    68 205 IblSODAAbnorm / Norm Check Each Hem in Appropriate Column

    Date: 03/01/2001

    24. SODA Serial Number

    Check Each Item in Appropriate Column25. Head, Face. Neck, and Scalp26 Nose27. Sinuses28 Mouth and throat29. Ears, general (internal and external canals; hearingunder item 49)30. Ear drums (Perforation)31 . Eyes, general (Vision under item 50 to 54)32 . Ophthalmoscope33. Pupils ( Equalityand reaction)34. Ocular molility (Associatedparallel movement,

    35. Lungs and chesl (Not including breast examination)36 Hear (Precordial activity, rhythm, sounds, and

    XXXXX

    XXXXX

    XX

    Abnorm /Norm37. Vascular system X38 . Abdomen and viscera (including hernia) X39. Anus (Not includingdigital examination) X40 . Skin X41 G-Usystem (Not including pelvic examination) X42. Upper and lower extremities (Strength and range o) X43. Spine, other musculoskeletal X44. Identifying body marks, scar, tattoos (Size and X45 . Lymphatics X46. Neurologic (Tendon reflexes, equilibrium, senses. X

    47. Psychiatric (Appearance, behavior, mood, comm., X

    48. General systemicNOTES;Descnbe every abnormality in detail. Enter applicable item nbrbefore eachcomment.

    04/24/2002 MID: 200000543342 Page # 1

    NCTA000010828

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    Conversalional Voice Test at 6 feel [XJPassQFail Record Audiometric Speech Discrimination ScoreRight Ear Left Ear

    500 1000 2000 3000 4000 500 1000 2000 3000 4000

    50. Distant Vision 51 a. Near Vision 51 .b. Intermediate Vision - 32 inches 52. Color VisionRight 20/ 20 Corrected to 20/ Right 20/ 20 Corrected to 20/ Right 20/ Corrected to 20 1 (X)PassLeft 20/ 20 Corrected to 20/ Left 20/ 20 Corrected to 20/ Left 20/ Corrected to 20 1 Q FailBoth 20/ 20 Corrected to 20/ Both 20/ 20 Corrected to 20/ Both 20/ Corrected to 20 153 Field ofVision 54 Heterophoria 20' (in prism diopters) Esophona Exophoria Right Hyperphoria Left Hyperphoria(X]NormalOAbnomial 0 0 0 055 Blood Pressure 56. Pulse 57 Urinalysis 58. ECG (Date)Sitting, mm Systolic Diaslo/ic (Resting) (Jfabnormal, give results) Alburmin Sugar

    127 83 85 [X]Nomnal QAbnormal59. Other Tests Given NONE60. Comments on History and Findings: AME shall comment on all "YES" answers in the Medical History section and for abnormal findings of the examination.

    (Attach allconsultation reports, ECGs, X-rays,etc lo this report before mailing)

    10. HAS NON-ICA10 PILOT LICENSE ; FR. GUIANALimitation 1:NoneSignificant Medical History QYes [X]No Abnormal Physical Findings QYes [X)No61. Applicant's Name 62. Has been Issued - QMed Cert. [X)Med. andStudent Pilot Cert.MOUSSAOUI.ZACARIAS ' QN o Certificate Issued - Deferred forFurther Evaluation

    QHas Been Denied - Letter of Denial Issued (Copy attached)63. Disqualifying Defects (list by item number) NONE64. Medical Examiner's Declaration - I hereby certify that I have personally reviewed themedical history andpersonally examined theapplicant named onthis

    Date of Examination Aviation Medical Examiner's Name Certificate/Form Nbr03/01/2001 LYNN.CLYDE A, FF1278810

    Street: 1317 BROOKHAVEN BLVD AME Serial Number 07448City: NORMAN State: OK Zip: 73072-3638 AME Telephone: 405-329-2625

    04/24/2002 MID: 200000543342 Page*: 2

    NCTA000010829

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    WITHDRAWAL NO TICERG: 148 Exp osition, Anniversary, and Memorial CommissionsSERIES: 9/11 Commission Team 5

    NND PROJECT NUM BER: 46009 FQIA CASE NUM BER: 28613WITHDRAWAL DATE: 12/27/2007

    BOX: 00018 FOLDER: 0001COPIES: 1 PAGES: 36

    TAB: 3 DOC ID : 31138967

    j^^ESSRESTJUCTIEDThe item iden tified below has been withdrawn from this file:

    FOLDER TITLE: Kephart W F: Airman Records of HijackersDOCUMENT DATE: 04/25/2002 DOCU MEN T TYPE: FormFROM:TO:SUBJECT: Airman File for Ali Ayedh Al-Ghamd i (Not a Hijacker)

    This document has been withdrawn for the following reason(s):9/11 Personal Privacy

    WITHDRAWAL N OTICE

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    TEMPORARY AIRMANCERTIFICATED _ iJ

    NCTA000010869

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    NCTA000010871

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    CATSComputer Assisted Testing Service1 -000-9^7-4220

    Kedertil A vi ati on AdministreitionAirman Computer Teat Kuport

    EXAM TITLE: Commercial Pilot: Airplane (CAX)NAMR: ALSHHIIHr. MAKWAN YOUSRl' 90121920001505191ID NUMBER: 05091978 TAKE: 1DATE: 12/19/20.00 SCORE: 73 GRADE: Pasfl

    Knowledge area codes in w h i c h questions were answered incorrectly.See appropriate Advisory Circular (AC) Knowledge Test Guide available viath e Internet: http://afs600.fcia.gov/data/advisorycircular/ac60-25d.pdfA single code may represent more than one incorrect response.B07J2S 1508164 Bl lH342 H303H574 H300108 H307A02 H308H317 H66H105 123

    EXPIRATION DAT12: 12/31/2002

    Authorized instructor's statement. (If applicable)I have given Mr./Ms. additional instruction ineach subject area shown to be deficient and consider the applicant competentto pass the test.Last(Print clearly)

    Signature _.

    Initial Cert. No. Type

    NCTA000010872

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    LufALLENTRIES IN INK

    Airman Certificate and/or Ratina Application

    ADDITIONAL ADDRESS INFORMATIONALSHEHHI. MARWAN YOUSEF.tji. firal. Middle)

    Security Numbra Number 2636862

    12^21/2000

    Ptmnnt Malllna Address: ' ' U.S.

    'JP.O.Box. Stale, Zip Cod* NOKOWis

    ^AddrMt th fppllctnt fwcruasts lh cfrtHlctt* p4*/if tofe,,;',, -'518 W LAUREL ROAD

    i,P,O.BoX ; .' ;:?OtY. Stat.. Zip Coda NOKOMIS

    - l:Phv*lcl Description n(*rd

    NCTA000010873

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    TEMPORARY AIRMAN CERTIFICATE

    I xi AIRPLANE SMOLE ENGINE LANDINSTRUMfNr AIRPLANE

    NCTA000010874

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    XIV. CONDITIONS OF ISSUANCETins is an interim certi f icate issued subject to the approval of the Federal AviationAdministrat ion pending the issuance of a certi f icate of greater duration. It becomes void1 Upon the receipt of a certif icate of greater i/nration to replace it;2 Upon a finding by the FAA that an error ha 3 been made in its issuance;3. Upon a finding by the FAA that i t was issui id illegally or as the result of fraud or mis-representat ion;4 Upon the refusal or failure by the holder to accomplish a flight check by a Flight ,Standards Inspector if so requested; an d5 In any case, at the expiration of 120 days from date of issuance. .- :

    . - , *

    NCTA000010875

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    lYPf OR t > T lNT AH FN T n i E l ih INK

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    Sffr-'&S&f.*;'*

    NCTA000010877

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    tree o* P f l n v r A L L E H T I O E S w m e

    Airman Certificate and/or Ratina Application

    ADDITIONAL ADDRESS INFORMATION .ALSHEHHI, MARWAN YOUSEF.Hm*(U.Fr1. Middle)

    :' Social Security NumberCtrtiflott*Number

    ;Ptmnv>t UalltnaAddnst

    /;518 W LAUREL ROAD.:.-.. . . ' ;

    NOKOMIS - :.

    ' : : . - f i . ^ S&T- n fe S MSsSAefctoM-tftetipoacMf nautatt th e cert/ffc/ A* swtf to:

    SSS-*%s>;i1;?;.V>-"-.'.:"ft ' ' ;KObuflf-ml ni**itntlnPttv*K*l Description McnterM:

    NCTA000010878

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    CATSComputer Assisted Testing Service1-800-947-4228Federal Aviation AdministrationAirman Computer Test Report

    EXAM TITLE: Instrument Rating-Airplane (IRA)KAMB: ALSHBHHI, MARWAM YOUSEF 90110620004207828-JO NUMBER: 05091978 TAKE: 1bATE: '11/06/2000 SCORE: 75 GRADE: Pass

    .^Knowledge area codes in which questions were .._. * - . - . .fI'vSee appropriate Advisory Circular (AC) Knowledge Test Guide availablej' the Internet: http://af8600.faa.gov/data/adviBorycircular/ac60^25d.pdf'%;.'A single coagnisay- represent more than one incorYfec'tr/refl'p'diifig"^;^iWaib: . : - 1 2 1 . 161 H342 208 J 3 5

    v i a

    ; | '2'BXP"iRATION DATE : 11/30/2002

    I^i-Authorized instructor's statement. (IfJl^Ii'ihave given M r . /M s .Breach subject area shown to be deficientIpito'.pass the test.

    - . : - ^^^W^'*;;^ii!;^Sti'*X;Vv'vv.^^v^^S*fe| ' ' : - ' : * . ^ ' ' . . : - : : ' i : ' ; ^ . ' . - ' ; - - : : ' i . f i ? ? V < . < : - \->;r'^'^-.--'-,i:;^ i;; i.and

    J|p(Priht clearly)I ^"Signature"

    J^^pviv^ : ; ' ; ,

    -initial_

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    " M l ) S T M r . O * v * H < 36 f t , ,It

    A .fit*'OATEOfMIIH j lOM j WpQHf(Kcuauwn 1 w 1 zSAoiE E N f l t N E L A N D

    . : : ' . 4...;,.-i>^i^^ti^mM ( D " W d U M w u w f i lu**Mi*emrc

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    f . r ~ ~1 Qr.'srrc'. rr::.--1: Airman Certificateand/or Rating Application

    ( J ArtdHJOn*) JUBofl [Xj Arpit SgI ] FMghl,n.ructo< [ I fauu

    ALSHEHHI . MARWAH Y O U G E F1**!*51 6 W LAUREL TOAD

    U Du younow twiM). n* IMV*I vw* toM* f AA Prtm CM|X) .

    MriKfl C incT ' J[ J 1*1 THJRDCo> HmuUnl tfrvg 4N utalw4r

    H. CfrttrtM*or Rjflng AppHod Tor OA !*of.A rn **l-n*oh-N*"""""" . UCElM

    1 1" Mwr i.cow*nh 4.FkwMt IOhowrnCh

    1C I.Maiw WMll.ocnorOokHkofc" _ .,.__.._,..1Cunciiwofiaiimik

    1 |0 1CMowc'wi'"SSZfm '-.RECORD Or PILOT TIMtFR Tlme-AI Clgorln ToldlFit TTmo-AI C*l*podM Flgrrt IrntnFK Tim* AllCttegoriMSoloIntoAfrplwMCrouCountryInun AlrpliMNghtIranAlrptorw NighvCroMCntry Fife lOOnmIratn Akplne NlgN TO/Lmrai Aplne lmtrumntImtn An>mHn InPrw 80OmPriorTet1

    IV.HionMM M otMBlncwrngt

    [ ] R. BLACK BROWN t 1 f"~ix.ii.) N aiBfepiMCotnicni 0 ck.i,NimbM >.btai>ii

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    CATSComputer Asoisted Testing Service1-800-947-4228

    Federal Aviation AdministrationAirman Computer Test ReportEXAM TITLE: Private Pilot-Airplane (PAR)NAME: ALSHBHHI, MARHAM YOUSRP 90001420004604594ID NUMBER: 05091978 TAKE: 1DATE: 08/14/2000 SCORE: 83 GRADE: Pass

    Knowledge area codes in which questions were answered incorrectly. ___S

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    ; o ' 4 o . . o :ro 2POUT ALL EWTWES INWK

    Airman Certificate and/orRatina ApplicationADDITIONAL ADDRESS INFORMATION .

    ALSHEHHl. MARWAN YOUSEF.ame (Last Pint. Middle)Social Security NumberCertMcatt MumberData tMuad

    f: City. State. ZtoCoda ,NOKOMIS. ---. - .-.-^__^-''-- - -.v,. ' ' ; n.: f-L...-* _ '* / ,-J""- 1 "T. ' '' "' -v,* --'y M -';--'''. yr';i-t-/;JjN"*"e;

    r=riia

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    DEPARTMENT OFTRANSPORTAT ION

    CERTIFICATE OF TRUE COPY

    I HEREBY CERTIFY that the attached is a true copy of the originalmedical record of MARWAN YOUSEF ALSHEHHI dated July 24 , 2000,

    i file in the Aerospace M edical Certification Divisionthat I am the legal custodian thereof.Signed an d dated at Oklahom a City, Oklahomathis 25th day of April, 2002

    by JERRY K BO W ENSupervisor, Medical Records SectionAerospace M edical Certification D ivision

    C J W )Civil Aerospace Medical Institute1^*************************************************************************************

    I H EREBY CERTIFY that JERRY K BOW ENthe foregoing certificate is now, and was, at the time of signingcustodian of the aforesaid records,

    [1 1 faith and credit should be given his certificate as such.IN WITNESS WHEREOF, I have hereunto subscribedmy nam e and caused the seal of the Department ofTransportation to be affixed this 25thday of April, 2002at Oklahom a City, Oklahoma

    .RREN S.SILBEmAXOOTMraARREN: (Signature}Manager, Aerospace Medical Certification Division

    (Fi tk)Civil Aerospace M edical Institute

    Depar tmen t of Transpor ta t ion

    Form ( 9 - 6 9 )

    NCTA000010885

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    1.Application ForrjAirmanMedical*-* Certificate;ept For Shaded Areas) PLEASE PRINT" -

    10. Type of Airman CertMcate(e) You KoM:DNone D ATC SpecialistDAirline Transport D Right EngineerD Commercial DFlight Navigatora:A . 4 -

    O Right InstructorDPrivate^Student

    D RecreationalQOther

    12.Employer13. Ha Your FAA Airman Medcal Certificate E ver Seen Denied Suspended or Revoked 7

    DYes H.No tfyes. give date-Total Pilot Time (Clv*an Orty)15.Pt8montha

    M M / D O / Y Y Y Y18. Date of Last FAA Medcal Application

    NolMorApplicationM / D O / Y Y Y"Y"

    Do You Currently Uae A ny Medcation (Pnwcrlptlon or Nonpreacrlptlon)?lo D Yea (Ifyea, betow list medcatlon(*) used and cheek appropriate box ).

    - --ff^ *-*\&&**?3l. W3#%3*7.D.OO You Ever UM Near Vteton Contact

    It.WadlcM History-HAVE YOUEVR IM YOUR LIFE BEEN DIAGNOSED WITH. HAD. OR DO YOUPRESENTLY HAVE ANYi-OFtor every condition listed below. In the EXPLANATIONS box below, you may note - PREVIOUSLY REPORTSDJLNO CHANGE*~ '"

    ? ^Answer -ye' or no*' o( fte condition was

    r Frequent or severe headacnea (SHeart or vascular trouble ^Mffitaiy medical dttcMfgeSJ Highor low blood pressure^OzzInesa or fainting ipet t $0 Medcal rejection by military service

    5) Unconsciousness for any reason (^ Stomach, liver, or gRejection tor W e or health InsurancepiEye or vision trouble except glassesjf Hay feveror allergy QOther illness, disability, or surgeryuicide attemptQMotion sickness requiring medication

    Conviction and/Of AdmlnI>tratlv_Aot n HfirfptKr'- SiiJnjBfeictlon Page.YesQPF ilvdvgviftile intoxicated by.while Impaired by, or while under the2yHwtory of any convction(s) or administrative acfJon(s) Involvng anarji.af. suspension, cancellation, or revocation of drivng privleges orucatlonal or a rehabilitation program.

    YeaWO History of nontrafficconvict ton(s)(misdemeanors orfelonies).

    Exolariaitl

    19. Visits to Health Professional WithinUt*t3Years. O Yo (Explain Below) 0No See Instruction* PageDate Name, Address, andType of Health Professional Contultad Reason

    NOTICE WTioevor In any matur vritMn Viejurtsdletlon of any department oragency of tt* United Statesknowingly and willfully falsifies,conceals or covers up by any trick.hemo. or device a material fact.who makes any false, fictitiousfraudulent statements orrepresentations, or entry, may belined up to $250,000 or imprisonednot more than 5yean, or bom,Vi a US Code Sees. 100t;3571J.

    20. Applicant's National Driver Register andCertifying Declarations1 henby authorize the National Driver Register (NDR), through a designated State Department of Motor Vehicles, la furnish to the FAAInformation pertaining to my driving /coord -THIS consent constitute* utnorizailon for a single access to the information contained In the NDR toverify Information provided in this application. Upon my request, the FAA mall make the information received from (he NDR , if any , available formy review and written comment Authority. 23 U.S. Code 401. Note.NOTE- AU. pereone ualngthla form must sign It. NDR conaent, however, doee not apply unlentMa form leuaeda*anapplication for Medcal Certificate or Medical Certlflcat* and Student Pilot Certificate.I hereby certify trtct all statements and answers piovlded by me on this application form am complete and true to the best of my knowledge, and Iagree that they ate to be considered part of the basis for issuance of any FAA certificate to me. I have ado read endundenlandthe Privacy Actstatement that-accompanies this form

    Signature of ApplicantFAA Form 8500-8 (3-98) Supersedes PrevousEdition

    NCTA000010886

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    NOTE: FAA/Origlnal Copy of the Report of Medical Examination Must boTYPED22. UMght (pounflt) 2}.3M*m*ntofO

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    200000274022 Appl. ID: 1999252133 1. Appl. fors ofmed. Cert. Applied fJ1st02nd[X]3rd 3. Last; ALSHEHHI

    0 Airman Med. Cert. [X] Airman Med. and Student Pilot Cert.First: MARWAN Middle: Y 4. SSN: 888-00-7426

    jr. 3389 SHERIDAN ST#2566. DOB: 05/09/1978 Citizenship:10. Type of Arman Certificate(s) You Hold:[] Arline TransportQ Commercial11. Occupation: STUDENT

    City HOLLYWOOD7. HairClr.: BLACK

    [X]None0 ATC SpecialistF J Flight Navigator

    12. Employer

    St.: FL/Cou.: USA Zip: 33021-3606 Tel:

    13. Has Your FAA Arman Medical Certificate Ever Been Denied.Suspended, or revoked?Total Pilot Time (Civilian Only) 14. To Date: 12 15. Past 6 months: 1217.a. Do You Currently Use Any Meds. (Prescription or Nonprescription)?

    8. EyeClr.: BROWND StudentQ Flight InstructorD Flight Engineer

    QYes[X]No16. Last FAA Med. App. Date:

    9. Sex: maleQ OtherQ Recreationalrj Private

    Ifyes, give Date:(X) No Prior App.

    [X]NoQYes (If yes. list medicalion(s) used below.) Prev Reported

    17.b. Do You Ever Use Near Vision Contact Lens(es) While Flying? fJYes[X]No18 Medical History - HAVE YOU EVER IN YOUR LIFE BEEN DIAGNOSED WITH. HAD, OR DO YOU PRESENTLY HAVE ANY OF THE FOLLOWING?

    Answer "yes" or 'no tor every condition listed below. In the EXPLANATIONS boxbelow, you may note "PREVIOUSLY REPORTED. NOCHANGE" only ifthe explanation of the condition was reported on a previous application for an airman medical certificate and there has been nochange in your condition.

    Conditiona Frequent or severe headachesb Dizziness or fainting spellc Unconsciousness for anyd Eye orvision trouble, excepte Hay fever or allergyf Asthma or lung diseases

    YesDDDnQ0

    Conditiong Heart or vascularh High or low bloodi Stomach, liver, orj Kidney stone ork Diabetes1 Neurologicaldisorders:O.Y // ;jj^oyecr /o //ieorn\-tsions or'the Prtvacy Ac:. 5 U.S.C. 552a. a n d a i ry release or reproduction 1 7 1 1 1 . 1 1 ne mad e : ti...,.-^r-^tr.- - - v i i f i :hai < ramie.

    NCTA000010892

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    FA X 4059544889 AM0730/SECURITY

    U.S. Departmentof TnruporationFdralAviationAdministration

    ACTION: Request fo r Certified Recordsof Airman Documents

    8)004

    MemorandumD"E October 4, 2001

    Manager, Compliance and EnforcementBranch, A MC-730T" Manager, Medical Certification Branch,AAM-330

    AtmofBrenda L. Smith, AMC-73 1(405)954-7628 -Fax: (405) 954-4989

    Please forward to this office a certified copy of the complete file concerning the airmanlisted below. A computer printout of the airman data is attached fo r reference.N A M EMarwan Y. ALSHEHHI

    SSN888-00-7426

    Date of Birth05/09/1978

    If there is no airmen information available, please prepare a diligent search. Pleaseexpedite this request, these documents are needed M annn M posilble. We appreciateyour assistance.

    Mark W . Sweeney

    NCTA000010893

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    FEDERAL AVIATION ADMINISTRATION

    CERTIFICATE OF TRUE COPY?Y CERTIFY that the'attached is a true copy of the complete airman file pertaining to

    L Atta, date of birth September 1, 1968. Supporting documents are on file in the Airmento n Branch, Federal Aviation Administration, and I am the legal custodian thereof.

    Signed and dated at Oklahoma City, Oklahoma_ this 25th dayofApril. 2002 _by Mae McGary

    Supervisor, Certification Section C(Title)

    K****l

    led the!:, the II[ te as suq

    I HEREBY CERTIFY that M ae McGaryl ing certificate is now, an d was, at the time of signing Supervisor, Certificationistodian of the aforesaid records, an d that full faith an d credit should be given this

    IN WITNESS WHEREOF, I have hereunto subscribedmy name and caused the seal of the U.S. Department ofTransportation to be affixedthis 25th day of April, 2002at Oklahoma City, Oklahoma

    Harold K. Everett

    12100.1 (10-M)

    (Signature)Manager, Airmen Certification Branch(Title)Civil Aviation RegistryU . S. Department of Transportation

    NCTA000010894

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    ; iopni\UlrtlMiu f*irType o f rc r t i ( t c j ( c f s )

    a /;

    Al'l ' l U'A I ION K OK K I T L A C K M K N T O K LOST O K D K S T I t O Y K I ) .A M M A N CT.IM I R C : ,VI K ( S ) AM ) K N O W I . K I K . ' K . T K S T K K I ' O K T(S)

    r , . , / > ' &M:t!0v :?I' M I V A C V . M I : M i K l n f i t i t t i u i l i .i l h r r q t i l r u l i i iu l r r Mir a n i t i o i l l ) n T l l i c I t i l r r j i l A t l a l l n A i l ( S i i ( > i i i Mil- ( > r * i f l * f l i n r g f i m i f f* r r on t f t l c f r i4 uolrii thf A H /i* >;'-T;ilili K r n n i p k t r . |M*i-l inn iT n l > ' H i r S n i l l S r r i i r K ) N m i i l i r r ( SS N ) I t n | i i l i in l . t t n u i l n r i i f % n f r r r n r d i nulndlnrd In I h r ) W f m l B r l i i r f r c * l n ; f i r t r f tiwrt J J , _ . 1 Xm l i hr p n n r t r * iirs iii-A U M ' S ; if.. *" ( t r r i - i m i n r ( f i a t a l r i n r i i H I P t r n J I J r i f )/t u r m n l N n r r **lih Ih r f i rm K h m f th r K e d e n l A t l a f k ' M A c t o f HSU; r r p t ^ l i Ar ) iff \ /W

    I h > I n i l l i i i l n i t t N t u l i i . t ( c n i i Hl r i i t p l ( i > i r s IM i k U ' r i i i ln c % t t l i ( l ) l y i i f i l n i i i - n ( | i i a l l f Va t l j i n ; tu vipporl ln i r %t i i ! i lvr r f T n / m i f ln t rt let ti ft a t i d l a i * /?jt 1 -;l; r n c K * > f Irttn at . M o l e , uni t l u r i l i: tlf r n n n -HU ; ^ Hi i p n r l lu ' I n f n r i t D t l l t i n Inr i n t i l mmc u n c r m l n t : U i l U i d n a l t t m u t s n r t / u r [ |uallftrllnin In |'j* * ; .v I

    Suiom(CAI*i); n d to pr t ixldr i S i c u m r n f i fu r m J c r r t f i l m itidmtrruflrhr bcLp r t rwrrf i . J.I/' 'li'v'J\. . . // * 'V*'!- . - . '' ; ' - - . ; - , - ' . . - " ' . .-'."" lCcnif icn!eNuinbers( s) ' : -"-. 'Dalc fs jofl ssuancc ' , , ^ . - : ' : . o ; 7 Xj l, - ; ! . : ; r : : \ ; ! X . . - , . . - - : - . = ' ^ ^ v v - > ' : ; ;^ J/^ ^g^gn i P / ? i

    Comple te n a m e in w h i c l i c e i 1 i f i c : i t c was issued: ' ' / " i f ) nAMFiS,V- ; ."; Present m a i l i n g 33itKft'-' > : " ' . _ _ ^ " - . ' . . ' ' ' - . ' . ' : - '\,>'.;.&4^"- ' ' - " " ''&:^r:'-''&'*-***^^^

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